Individual
BROOKE BRACY HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
4561 MAINE, QUINCY, IL 62305
(217) 228-1085
(217) 228-1089
Mailing address
4561 MAINE, QUINCY, IL 62305
(217) 228-1085
(217) 228-1089
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032713
IL
1223G0001X
General Practice Dentistry
019032713
IL
Other
Enumeration date
08/18/2020
Last updated
04/26/2023
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